8/10/2019 Thucydides on the Plague Physiology of Flux and Fixation
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Thucydides on the Plague: Physiology of Flux and Fixation
Author(s): E. M. CraikReviewed work(s):Source: The Classical Quarterly, New Series, Vol. 51, No. 1 (2001), pp. 102-108Published by: Cambridge University Presson behalf of The Classical AssociationStable URL: http://www.jstor.org/stable/3556331.
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Classical
Quarterly
1.1 102-108
2001)
Printed n GreatBritain
102
THUCYDIDES
ON THE PLAGUE: PHYSIOLOGY
OF
FLUX AND FIXATION
...
.7Tp)To0V
,LEV
T77
KEaA7-
~
OE"piat
taXvpa,
Katccv
&OaajC,
pvOa'ra
,KaT
,
aoywats
KAptLflavE,
at
d
aVO'rS,
K
TE
O
apvy
i
Kat
'
yAcJaaa
E
^
aiLartc%7
v
Kav
7TVELCLa
daTo7ToV
at
svuWsEs
UoEo.
E7TELoa
av
Trv
7rTappoSt
KLl
3Pa'yXos
EyTEYKYVE
%'
K
vo
7V
o
oAA
^
Xp
'vco
9awev Eg
8T
aUTr)0
7
rovo
LE
dflX3S
laXvpoV.
Kat
7diTOE d
T77
KapStav
aT77rptELE,
davEaTPEE
u
E
avTr)V
eat
p
7rOKaOapscEt
Ost ~b7rat
aatL
iro
~tarpL~v
voLaal-EvaL Eltav E7trr uav,
Kat
avTat
(
Ti
raaAaLrwpa
~
Eya77s~.
b6et...
KEV'J7,
aTCaa/Lv
Ev
Sora
taX
vpo'v,
rorg pyv
LETal
-TraaTra
wri
avra,
oS
e
Ka
uocAA
icuTsEpov. aL tOdL mEateOrVEv7rthe)T
uaiolaaovgr'yav EpLC
v
EhVOUrEXAcopdV...
Tad
8
EVESr...
EETo...
-q
"EcfIEpoVrool
7TAELTOL
a-raiot
KaitESo/LatoL
TcO
rTO,
EVTOS
KavpaTOg
...
77
Eta~b~YOLEV,
E7TLKaTL0VTOtro
to hvoLaUTOra
ES
t
cv Kolatlav
t
EntAiKonhEs'aECoogiT
a
t
aofpS EhiyyLyvorrive7S
Kat
StappotaeS
ala
atKparov 7TLrTL7TTOVU7tarlSa7TOAAno arEpov
St'
s-rd
v
dpaOEVEda
a7TEkOEL'POVTO.
8ELE-L ap 8Ld ravvTSo% udLaroS VoJWOEV
ap.atLEVOV
-
V
qKEdaA-pw?rovsPV1_V
KaKO'v...
(Thucydides
.49)
Thucydides'
description
of the
great plague
at
Athens,
perhaps
the most celebrated
'paramedical'
passage in Greek
literature,
raises
questions
about
the
relationship
between
Thucydides' history
and
contemporary
medical
writing.'
However,
despite
much discussion of related
matters,
the
physiology implicit
in
Thucydides'
account
seems not to
have
attracted
scholarly
attention.
Physiological aspects
of his narrative
are here
discussed,
against
the
background
of
medical
texts and
especially
in relation
to
the
prevalent Hippocratic theory
that the
cause and
progress
of disease
depended
on
bodily
flux. It will be
seen that
Thucydides'
description
of
the
progress
of the
plague through
the
body
is
in
accord with classic
medical
doctrines of flux and
fixation,
and is based
on
a
relativelysophisticated
view of human
physiology.
It
is
beyond
the
scope
of this short
paper
to
explore
in full the wider
implications
of
these
findings.
Does
Thucydides
tailor his narrative to fit the fabric of known medical
theory,
or even to
prove
the
theory
correct? If
so,
this
may
have a
bearing
on his
objectivity
and
veracity
in choice and
presentation
of
evidence;
indeed on his entire
historiographical
method. Or does
Thucydides simply
use medical
knowledge
to
amplify
and
confirm data of
his own
observation and
experience,
in
order to describe
the
progress
of the
disease as
clearly
and
accurately
as he can?
The latter
view is
more
consonant with the
probability
that
Thucydides
took the existence and
importance
of
bodily
flux for
granted,
not as an
abstraction
propounded by
doctors,
but
as
a
matter
of common sense
and
common
knowledge.
From
a
modern
perspective,
bodily
flux
For
general
treatments of
this
relationship,
see
K.
Weidauer,
Thukydides
und die
hippo-kratischen
Schriften
(Heidelberg, 1953/4);
C.
Lichtenthaeler,
Thucydide
et
Hippocrate
vus
par
un
historien-medecin
Geneva,
1965);
and G.
Rechenauer,
Thukydides
unddie
hippokratische
Medizin
(Hildesheim,
1991).
In
the course
of useful
comments,
one of the
CQ
referees
invited
speculation
on the
implications
of the
findings presented
in this
paper
for
this
relationship:
some tentative
suggestions
are
accordingly incorporated.
I am
grateful
to both referees for their
careful
reading.
8/10/2019 Thucydides on the Plague Physiology of Flux and Fixation
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THUCYDIDES
ON
THE PLAGUE 103
may
seem
merely
a
strange
or mistaken
notion;
in the
fifth
century
B.C.t was an
accepted
fact
in
diagnosis
(see
further
below).
It
is
most
unlikely
hat
Thucydides
viewed he
occurrence f flux as in
any
way
theoretical
cf.
below on
contagion
and
acquiredmmunity),
nd
certainly
ot
as
a
theory
or whichhe
mightpresent
mpirical
corroboration.His evident
amiliarity
with the detailsof
bodily
routes
postulatedby
doctors or
the
course
of flux remains
emarkable.
Much has
been writtenon the
terminology
used
by Thucydides
o
describe
he
plague:
s it
technical,
emi-technical,
r
non-technical?2
age
argued
hat
Thucydides'
language
s
'technical';
arry
denied hat there
s
any
close
similarity
with,
or
debt
to,
medical
writings;
Dover,
n the courseof
valuable omments n
the
limitations
f
the
designation
technical',
as endorsed
Parry's
cepticism.
Commentators
udiciously
it
on
the
fence:
Rhodes
remarks,
This
prose
s
indeed
not
the
prose
of a
medical
writer,
but his
medical
vocabulary
is
extensive
if
not arcane . . . he is
indebted
to
[con-
temporary
medical
writings],
ven if he has
not
copied
them';
Rusten
writes 'The
vocabularyrevealsmanycoincidenceswith Hippocraticwritings;yet most of the
terminology
s
consistent
with
everyday peech
as
well';
and
Hornblower
inds
a sense
of
&KpPlda
.
.
which
leaves on the reader
a
strong impression
of clinical
precision,
irrespective
f
the closenessor otherwise
of the
parallels
which can
be
cited from
medical
writings'.3
he consensus eems
o be
that
Thucydides'
ognizance
f medical
expression
oes
not
lead
him to
replicate
echniques
f medical
writing.
Muchhas
beenwritten oo on the
pathology
f the
plague:
an it be
identified
with
any
known
diseaseor diseases? oole and
Holladay
were nfluential
n
arguing
hat
it
cannot,
because
over the courseof two
millenniaboth the virulence
f
any infecting
organism
nd
the characteristicsf the host
defencemechanisms
ould
change,
and so
thereforewouldthe clinicalmanifestations:heseargumentsarrested,but did not
completely
nd,
speculation
n candidate
microbes.
Poole
and
Holladay
were influ-
ential too in
suggesting
hat
Thucydides
was
way
ahead
of
contemporary
medical
science
n
that
he
anticipated by
about
1800
years)
awareness
f the
occurrence
f
contagion
and
(by
more than 2000
years)
recognition
of
acquired
mmunity
o a
specific
nfection.
This view
won
widespread
upport;
but
it
ought
to be
recognized
that
Thucydides
merely
ecords nd observes
details
apparent
n
the
particular
ase of
the
plague
the
effectsof
associating
with,
and
especially
f
caring
or,
sufferers
.47,
51,
and
58;
the
fact that the
plague
did not
strike
wice,
or if
it
did
was not fatal
2.51):
he does not
go
beyond
his to formulate
heoriesof
general
validity.
He
describes
he
2
Galen's
view
was
clear: whereas
Thucydides
wrote as an
L~3urrlqS
for
fellow
laymen,
Hippocrates
wrote as a
reXVtri7r
for fellow
professionals (7.850
K.).
3
D.
L.
Page,
Thucydides'
escription
f the
great
plague
at
Athens',
CQ
3
(1953),
97-119;
A. M.
Parry,
The
anguage
f
Thucydides' escription
f the
plague',
BICS 16
(1969),
106-18;
K. J.
Dover,
The
Evolution
f
Greek rose
Style
Oxford,
997),
115-16;
ommentaries f Rhodes
(Warminster,
988),
Rusten
Cambridge,
989),
and Hornblower
Oxford,
1991).
See also
W.
Nestle,
Hippocratica',
ermes
3
(1938),
1-38;
S.
L.
Radt,
Zu
Thukydides'
estbeschreibung',
Mnemosyne
31
(1978),
233-45;
C.
Lichtenthaeler,
'oDrTE
ap
LarpoL
7pKOV
TiO
7TPCYTOV
OGparevovreg
dyvola',
Hermes 107
(1979),
270-86;
J.
Jouanna,
Politique
et
medecine.
La
problkmatique
du
changement
dans le
Regime
des
maladies
aigues
et chez
Thucydide',
in
Hippocratica,
IH III
ProceedingsParis,1980),299-319;H. Erbse,Thukydidesiberdie Arzte
Athens',
RhMus
124
(1981),
29-41;
P.
Demont,
Notes
sur
le recit
de
la
pestilence
Ath6nienne
chez
Thucydide
t sur
ses
rapports
vec
a
m6decine
recque
e
l'6poque
lassique',
n
Formes
e
pensees
dans
la
Collection
Hippocratique,
CIH IV
Proceedings
(Geneva,
1983);
J.
W.
Allison,
'Pericles'
policy
and the
plague',
Historia
32
(1983),
14-23;
also
O.
Wenskus,
reviewing
Hornblower
omm.,
Gnomon2
(1990),
577-9.
8/10/2019 Thucydides on the Plague Physiology of Flux and Fixation
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104
E. M.
CRAIK
effects of
contiguity,
rather than the
phenomenon
of
contagion.
This
does
not
differ
substantially
from the
observations of
a
Hippocratic
doctor at
Thasos,
noting
that
a
particular epidemic
claimed few female
victims,
but
many young
men who
frequented
the
palaistra
and
gymnasium (Epid. 1.1).4
Again,
as in the case
of
flux,
we are
not
dealing
with
'theories' but ratherwith matters familiar
to doctors
through
observation,
and so
known
to
at
least some of the
general populace.
Inference from
medical
observation
may
be
quite
correct
(contiguity
and
contagion)
or
only partially
correct
(flux
and
fixation);
or indeed
totally
incorrect.
Thucydides'
account
is not a
mere list of
symptoms.5
This
description
of
experi-
ences common to
many
sufferers s
structured n a
way
that is reminiscent
of,
but
does
not
replicate, Hippocratic
case
studies of individual
patients.
Thucydides
describes
the
progress
of the
plague
down
through
the
body,
a
capite
ad calcem. In
summing
up,
Thucydides
states
that the
plague
(KaK4V)
went
through
the entire
body
'after
starting
from
above,
and
settling
first
in the head'.
There
is a
clear
ordering
of
stages,
stressing
the downwards
course:
irpc~rov
_PLv
first'
high
fever
struck the head and the
eyes
became red and
inflamed;
EU;0s
'very
quickly'
the
parts
inside
(inside
the
throat)
were
suffused with blood
and
respiration
was
affected;
sELTra
then' there was hoarseness
and
sneezing;
&v
o0
iroAA,,
Xpdvo
'in a
short time'
the trouble
(7ro'vos)
went
down
to
the
chest;
Kat
rTOdrE
and
when'
(not
a
new
stage,
but a
possible eventuality
in the
same
region)
it
lodged
in the kardia
bile was
discharged;
after the disease
(vodar'ra)
went
on
to
the koilia
there
was
uncontrollable
diarrhoea;
the
extremities of
survivors
were
commonly
affected.
The
adverb
iv-r6~
twice
used in
the narrative shows
some interest
in
the internal
workings
of the
body.
To
Hippocratic
doctors,
health
depends
on
harmony
of
the humours and of
body
fluids
more
generally,
and disease
is seen
primarily
in terms of
fluid imbalance. As
fluids
provide
visible and
palpable
evidence of
organic
constitution and
change,
observation
of
their
motion in
or from
the
body
is
of
paramount
diagnostic
and
prognostic importance.
Theories
of
bodily
structure are
conditioned
by supposed
routes
and
conduits of
fluids
in
motion and
supposed
sites
of
coagulation,
fixation,
or
blockage.
The
body
is
viewed as
having
a
range
of
important
aurr7Axva
innards',
linked
by
solid
strings
such
as
vEvpa
(ligaments, etc.)
and hollow tubes
such as
Af6IEs
(vessels,
etc.)
of
various
kinds.
These views
may
seem
simplistic,
but the
body
is in fact
composed
largely
of
water;
pus,
vomit,
and other
abnormal fluids are
obviously
indications of
disease;
many
kinds
of illness do lead
to a
sensation of
swelling,
or
visible
swelling;
and
internal
blockage
does
lead to
trouble. The
common
experience
of
flux and fixation in head
colds,
and the observation that fluids flow downwards or into
an
available
space
(VM
18,
Loc.
Hornm.
0,
etc.)
doubtless
contributed to the
develop-
ment of
hypothetical
schemes
of
bodily
flux.
Theories of
bodily
flux and
fixation feature
explicitly
or
by
implication
as causes
4
J.
FC
E
Poole
and
A.
J.
Holladay,
Thucydides
nd the
plague
of
Athens',
CQ
29
(1979),
282-301;
A.
J.
Holladay,
New
developments
n
the
problem
of the
Athenian
plague',
CQ
38
(1988),
247-50.
See
also J.
Longrigg, Epidemic,
deas
and
classical
Athenian
society',
in
T.
Ranger
and
P.
Slack
(edd.),
Epidemics
and
Ideas:
Essays
on the
Historical
Perception of
Pestilence
Cambridge, 992),
21-44,
esp.
36
withn. 15.
'
See
A.
Roselli,
Some
remarks bout
the
accountof symptomsn Diseases I andInternal
Affections',
in La
maladie
et et
les
malades dans la
Collection
Hippocratique,
CIH
VI
Proceedings
(Quebec,
1990),159-70,
on the
mportant
lace
of
symptoms
n the
description
ndclassification
of
diseases;
lso W
D.
Smith,
Analytical
nd
catalogue
tructuren
the
corpus
Hippocraticum',
ibid.
277-84,
on
the
prevalence
f
cataloguing
ather han
reasoned
rgument
n
archaicmedical
texts.
8/10/2019 Thucydides on the Plague Physiology of Flux and Fixation
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THUCYDIDES ON
THE PLAGUE
105
and concomitants
of disease in
many Hippocratic
treatises.6
Aff.
11 is
typical:
[Kalaog]
ylvErat
7
XoA'Ois,
rav
T70'
acaTros
KacTaaru-rp
,
'[burning fever]
arises
from
bile,
when this
gets
stuck in the
body'.
There are
many
variations,
but
these
features are
regular:
fluids are attracted to
the
head;
flux from
the head
follows;
the
flow makes its
way
to various
points
where
spontaneous
or induced
elimination, by
bodily
orifice or
by
an
opening
created
by
surgical
intervention,
and/or local
impaction
occur.
The
nature of the fluids in flux is not
always
mentioned
(but
bile and
phlegm
are
most
commonly
implicated;
blood too
may
be
subject
to
flux;
often the doctor
hazards
a
guess
as to
which
fluid or
fluids
may
be
on
the
move):
the
apparent
route of the
fluids
is more stressed
than their
supposed
nature.
In
Thucydides'
account of
the
plague,
the
verbs
KaTrafat'vwv
and
irTKaTLE'vaL,
with the
explicit
avwGtEvdpdcqLEvov
show
that the
plague
makes its
way
down
through
the
body
in the
classic fashion
of
flux;
and
the
verbs
Ur-qpt,ELv
and
'"SpvaoaL
learly
indicate
the classic
problem
of
fixation
at
trouble
spots. Hippocratic
fluxes
regularly
include flux to
eyes,
chest
and
belly,
all hit
by
the
plague.
Flux
to
the chest
(lung)
is
the
cause of
the most common
Hippocratic illnesses,
ranging
in
severity
from
uncomplicated
respiratory
infections
to such
severe
diseases
as
pneumonia,
pleurisy,
and
phthisis.
In
Thucydides'
narrative,
an initial
flux
of blood
is
implied
in
the
adjective
aliarcTr]:
such formations
as
7o;Tr0s,
XoAC0d'rs,
,AEypLarr;6SY
are used in medical literatureto
describe the
appearance
of
body
fluids,
not
of
body parts;
for
alpardrsg,
cf.
Coac.
2.437,
Morb.
2.54, etc.,
of
spittle;
Morb.
3.16,
of urine.
In some
medical
texts,
the route of flux is
specified:
sometimes
the
vessels,
some-
times
particular
bodily
'passages'
which
open
up
for the
purpose,
sometimes the
trachea
(conduit
to
respiratory system)
and
the
oesophagus
(conduit
to
digestive
system). Thucydides is sufficientlyaware of this contemporary physiological theory to
incorporate
a
version of it in his narrative.
He does so with
typical economy.
From
parallels
in
medical
works,
it is evident that
Thucydides
here
uses the
expression
rd
EVTOS,
7
rE
adpvy
KaLt yAdcaaa
the
inner
parts,
throat
and
tongue'
to indicate
trachea and
oesophagus
and
that
these are
the
implied separate
routes of
noxious
matter
to the
chest
(lung)
and to
the
belly
(digestive
tract).
The
use of
yAcZiaaa
and
Oadpvy?
n
conjunction
for trachea
and
oesophagus
occurs in
Hipp.
Anat.,
where the
body
is described
in terms of these
two
routes.7
The two
terms occur
together
also
in Morb. 1.29: as a
result
of
avaoo
'burning
fever',
8
yA-uaaa
Kat
-q0apvY6
TprXvErat
7"E
Kat 77patvWrat.
The terminology in theoretical accounts of bodily flux, where trachea and
oesophagus
are
specified
as
routes of
flux,
is
analogous
to that
of
Thucydides:
cdpvy
is
regular
for
trachea,
and
ardo'paxos
or
Thucydides'
yAcaaa.
The
author
of Glands
lists seven
types
of flux: the first three-to
ears,
eyes,
nose-are
regarded
as
'natural',
presumably
because the
route
is
directly
from
the head. The
last
two,
to back and
hips,
flow
through
the vessels. The
remaining
two
go,
Gland.
11,
St'
7TEp4
qs
E~9d
pvyya,
S
au'odaXOv
by
the
palate
to
the throat
and to the
oesophagus'.
It soon becomes
evident,
Gland.
14,
that these two
fluxes,
both
beginning
from the
palate, correspond
with flux via
trachea
to chest and flux via
oesophagus
to
belly:
the author
distinguishes
flux
~rlaw...
8.'
~"Ee
pr.
.
.
14v oLALlv...
.
flux 'behind
(sc.
by oesophagus,
situated behind the trachea) by the palate to the belly' leading to diarrhoea, and flux
6
See
E. M.
Craik,
Hippocrates:
laces
n
Man
Oxford,
1998),
16
and
131-43,
esp.
132.
7
On these
terms n
Anat.,
see E. M.
Craik,
The
Hippocratic
reatiseOn
Anatomy',CQ
48
(1998),
135-67,
at 141-2
and
153.
8/10/2019 Thucydides on the Plague Physiology of Flux and Fixation
6/8
106
E. M.
CRAIK
8L'
vITEp7S
E77
apvyya,
'by
the
palate
o
the
throat',
affecting
obs nrvEpovas
the
lungs'
and
leading
to
consumptive
conditions.
This
use of 'throat' is found not
only
in
Gland.
11,
14 but also in
Carn.
16,
where
flux
from the
head
goes
4s
T-v
"7Ep
qV7
Ka
mrev
acpvyya
Kc Tv
rvEvlova
Kat
E
71)V
?v lAAvKofALI77
to
palate,
hroat,
ung
and
the rest of the
(sc.
upper) cavity'.
There
are, then,
two
clearly
differentiated
routes taken
by
the
plague: firstly, by
trachea
(to
lung)
and
secondly by
oesophagus
(to
belly,
lower
digestive
tract).
There
are also two
clearly
differentiatedareas
affected:
firstly
the chest
(lung
and
kardia),
and
secondly
the
belly.
The two routes do not
exactly correspond
with
the two
areas,
but
Thucydides'
narrative
is so
compressed
that this is
telescoped.
Chest and
belly
correspond
with
upper
and lower
(thoracic
and
abdominal)
cavities,
separated by
the
diaphragm.
Noxious matter
eliminated from
the
mouth,
whether
by coughing
or
by
vomiting,
both indicated
here,
comes
from
the
upper cavity.
There is no indication in
the statement
on the kardia
that the
plague
has moved on from the
chest;
indeed
the
use
of
oo'dE
with the
optative-as
LSJ
I.2a,
'(in
the
case) when', expressing
an event
which occurred
often-not
6ETra
with
indicative
'then' indicates that it is still in
the
upper cavity.
As is
regular,
temporal
and
conditional clauses are used
to indicate the
different sites
of flux.
Flux which
lodges
(note
the
idea
of
fixation)
in the
kardia
leads
to
painful
evacuations
of all kinds of
bile;
to
vain
retching
and
strong
convulsions.
What and
where is the
kardia? In
literary
texts,
it is most
commonly
the
heart,
including
the heart
as seat
of
emotion,
as
(with
medical
overtones)
A. Ch. 184
7TpooaEU17
KapStaS
KAV
Vlov
XoAg^
and
E.
Med. 245
leavaE
Kapslav
daa7s.
Some
have
supposed Thucydides
to refer
literally
to
the heart here.
However,
although
kardia
can of course
denote the
heart in
anatomical
contexts in the
Corpus
(as
in Cor.
passim,
Cam., Oss.,
and
elsewhere)regular usage
of
the
term in
physiological
contexts
(as
in
Epid.
and
elsewhere)
is
rather
vague.
(See
further
below.)
Other commentators have
taken
Thucydides'
reference
to be to the
cardiac
orifice
at
the mouth
of the stomach.
This
anachronistic
explanation,
endorsed
by
',
and recorded
by
LSJ
s.v.
II,
is based
solely
on
Galen's
statement that
'the
ancients'
used
this
name;
Galen here
imposes
his
own
superior
anatomical
knowledge
on his
idealized
Hippocrates (Gal.
5.274-5
K.).
LSJ
cite Prorrh.
1.
72,
but
the
expression
there,
Kap&'
r7dvos,
is not
specific.
In the
Thucydidean
passage,
the kardia
is
in
the thoracic
cavity
but,
as
the source of
vomit,
is
involved
with
digestion
and so is
apparently
a
point
en
route to the lower
abdominal
cavity;
for
flux
which
may
stop
at
a
point
in its course the
flux to back and
to
hips
via the
spinal
fluid
in Loc. Hom.
and
in
Glands
may
be
compared.
The
process
of
digestion
was
imperfectly
understood,
and
there
was
little idea of
what
happened
in
the trunk:
for
instance,
the
totally
mistaken
view
that some of the
fluid swallowed went
to
the
lung
was
common. The
connection of
the
kardia with
digestion
is
apparent
in its
links,
especially
when
symptoms
are
being
recorded,
with the
hypochondrion,
he area
just
below the
diaphragm,
the
abdomen,
as
Aff.
14-15,
Prorrh.
1.
72;
but
for the com-
monly
supposed
position
of the
kardia
itself
avw
rjv
bpaEVWov
above
the
diaphragm',
see Morb.
3.14.
The
term kardia
s
used
by
the
Hippocratics
in much the
same
range
of
senses as
the
term
praecordia
is used
by
Celsus:
it is
inconsistently
an area
in front of
the
heart,
or
an
area in the
upper
abdomen.
The area is
vaguely
described
in such
prepositional phrases
as
rrt, KaT,
~, rapd or
rTEp
Kap&'7v,Aff 15, Epid. 5.63, 5.80,
6.7.5,
7.3, 7.10,
Morb.
2.48.
And it is
implicated
in a whole
range
of
general
aches and
pains,
as
: dao
os~
ES
Kapit)V,
PrOrrh.
1.83
~
Coac.
2.310,
and for
pains
in similar
regions
cf. Morb.
2.5;
compare
also the
plaintive
Ka
7riv
Kap83'lvV
yvoleUOat
~
g,
Epid.
7.11.
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THUCYDIDES ON THE PLAGUE
107
The most
common use of the term
kardia,
both
by patients
reporting
their
symptoms
and
by
doctors
commenting
on
them,
is
to indicate an
area in the
upper part
of the
body,
where
peccant
matter
might
accumulate,
often
causing pain
or
nausea,
or
a
burning
sensation
(like
'heartburn',
cf.
Kap3&aAyla,Kap8LcoylCo9,
ap&'js
rdovos)
and from where it
might
be
evacuated from the mouth.
Just as
(typically phlegmatic)
stuff which
settled
on
the
lung
was
eliminated
by coughing,
so
(typically
bilious)
stuff
on the kardia was eliminated
by
vomiting.8s
But doctors were
frequently
non-committal
as to which fluid
was
involved: the kardia is said to be associated with
a trouble which
might
be caused
by
bile or
by phlegm, Aff.
14,
Morb.
2.5. Elsewhere
too,
the
kardia is
associated with
phlegm,
as when
phlegm
accumulates
in the
Kapst-q
and
ardoLaXOg
(oesophagus) compressed by
the
womb which had wandered from
its
proper place,
Mul. 2.200. And
perhaps
the closest
parallel
to
Thucydides'
usage
is that of Morb.
Sacr.
9,
where the verb
JrMKaTappE'
s
repeated eight
times,
in
6, 8,
10:
descending
phlegm
is said to
go
to
the
KapO3(r
and
aUrTOa,
lso
(equivalent
expressions)
to the
TAEUgjWV
nd
KapS/8T.
The rest of the narrative
is
straightforward.
When the
disease
'got
down
to' the
KOLALa
belly'
(that
is,
not stomach but entire
lower
digestive
tract)
severe irritation and
uncontrollable diarrhoea
ensued;
cf.
Aff.
23
r',g
KOLtAtr)
TraV7TmCraaut
KC
VKW~V,
W
Os
osEFLd
t'ArJs.
The narrativeends with stress
on the
extraordinary
course of
the
plague
to
the extremities: survivors
frequently
had lost
genitals,
fingers,
or
toes;
or had
gone
blind.
While the course
of the
plague through
the
body
follows
the
general
pattern
of
disease-inducing
flux,
the
plague
differs from more familiar
Hippocratic
diseases in
that it
attacks not one but
many parts
of the
body.
There remain the much-noted
coincidences in
vocabulary
with the
case
histories of
Epidemics(KaraaK
7rrw7
only Epid. 3.8;
rrlKarnAO9E
Epid. 7.107) and the old question
of
a
possible
connection between the
constitution of
Epid.
3.2-16
and the
year
of
the
plague
described
by Thucydides.
It is
certainly probable
that
Thucydides,
who had
strong family
and
personal
connections with Thrace and
Thasos,
was
familiar
with the
North Greek
medical
tradition to which the
Epidemics
belong.9
However,
this
examination of
the
physiological
basis of
Thucydides'
narrative
suggests
that he
may
have read
quite widely
in
medical texts. It is clear that he subscribed to the common
medical view that flux and disease were
inextricably
linked;
and
that he took some
interest in the mechanics of the
process.
There
are certain
affinities with theoretical
schemes of flux
(probably
widespread,
but best
known to
us from
Loc.
Hom., Glands,
and Cam.), and there are affinities with particular cases of flux (widespread, and
clearly
described Morb.
Sacr.,
Int.,
Aff).
Thucydides may
have
been
familiar
with at
least
some
of
those
works,
and
it
is
likely
that at least
some of
them were in circulation
in
fifth-century
Athens.
That
Thucydides
had an
extensive medical
knowledge
is clear. The
ways
in which
he
adapted
the
ideas of
contemporary
medicine
to
serve his own
literary
and his-
toriographical
ends
are
complex.
The evidence
presented
here-and
this
applies
to
8
The fact that the
kardia
s a
region
associatedwith
bile,
which
s in turn most
commonly
associatedwith
the
liver,
may
ie behind he
puzzling
tatment f Morb. .36 that he name
kardia
might
be
given
to
prrap,
he liver:
cAydi
7r
17rrap
r7ep
ol
rra&r
Kap8Lv
KaAoUtLV.
9
The
possibility
hat
Thucydides
met Democritus nd
Hippocrates
n the Abdera
region
s
exploredby
D.
Procter,
The
Experience
f
ThucydidesWarminster,980),
40-1.
See also
the
works ited
above,
n.
1,
especially
G.
Rechenauer,
4,
16-17and
cf.
J.-E.
Dugand, Hippocrate
&
Thasos et en
Gr6ce
du
nord' n
CorpusHippocraticum,
IH
II
Proceedings
Mons, 1977),
at
233-5.
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108 E. M.
CRAIK
terminology
and
structuring
of
narrative as well
as to its
pathological
and
physio-
logical substance-suggests
that he
had
his
own
'take' on this
material,
but
not
that he
distorted
it;
also that he
neither made nor
intended
to make an
original
contribution
to
medical debate.
Kyoto University, apanand Universityof St Andrews E. M. CRAIK
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